Provider Demographics
NPI:1538412713
Name:CHALK, STEVEN J (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:CHALK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4775 W DAYBREAK PKWY
Mailing Address - Street 2:STE 102
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-5139
Mailing Address - Country:US
Mailing Address - Phone:801-571-1338
Mailing Address - Fax:801-516-4438
Practice Address - Street 1:4775 W DAYBREAK PKWY
Practice Address - Street 2:STE 102
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-5139
Practice Address - Country:US
Practice Address - Phone:801-571-1338
Practice Address - Fax:801-516-4438
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA32444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor